Seronegative AI Inflam arthropathies Flashcards Preview

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Flashcards in Seronegative AI Inflam arthropathies Deck (21):
1

Where does ankylosing spondylitis affect?

Spine and sacro-iliac joints

2

What eventually happens in ank spondylitis?

Fusion of intervertebrla joints ("bamboo spine") and SI joints

3

Are females more affected in ank spon?

No males are 3:1

4

What do pateints with ank spon present with?

Pain and stiffness in back and SI joint
extra-articular features - enthesitis, dactylitis, ANTERIOR uveitis, plantar fasciitis, achilles tendinitis

5

Syndesmophytes are what?

Bony spurs from vertebral bodies seen in ank spon

6

What HLA is ank spon associated with?

HLA-B27 (90%)

7

Why is ank spon known as the "A disease"?

Axial arthritis
Anterior uveitits
Aortic regurgitation
Apical fibrosis
Achilles tendintitis
Amyloidosis
plAntar fasciitis

8

The Modified New York Criteria for Diagnosis of AS is what?

1. Lower back pain for 3 months - improved with exercise and not relieved by rest
2. Limited lumbar motion - reduced Schobers test (<19cm)
3. Reduced chest expansion
4. Bilateral grade 2-4 sacroilitis on x-ay
5. Bilateral grade 3-4 sacroilitis on x-ray

Definite diagnosis if 4 or 5 plus 1, 2 or 3

9

What treatment options are given for AS?

Physiotherapy
exercise
OT
Simple analgesia (paracetamol or NSAIDs)
DMARDs for more aggressive disease

10

Describe the basics of psoriatic arthritis.

Inflammatory asymetric oligoarthritis
Sacroilitis
Spondylitis
Dactylitis
Enthesitis (achilles tendinitis, plantar fasciitis)
Eye disease
Nail changes

11

What nail changes occur in psoriatic arthritis?

Pitting
Onycholysis (lifting of the nail from it's bed)
Subungual hyperkeratosis
Colour change to yellow-brow
Fungal nail infections can occur

12

Psoriatic arhritis occurs in what % of people affected by skin psoriasis?

30%

13

What bloods are seen in psoriatic arthritis?

Raised inflam markers
Negative RF

14

On x-ray what changes are seen in psoriatic arthritis?

Marginal erosions
"whiskering"
"pencil in cup" deformity
Osteolysis
Enthesitis

15

What is enthesitis?

Inflammation of the site where tendon or ligament inserts onto the bone.

16

What treatment can be given for psoriatic arthritis?

Physiotherapy, Ot, Orthotics, Chiropodist
NSAIDs
Corticosteroids/ joint injection
DMARDs (MTX, SZP)
Anti-TNF (Etanercept) - most effective agents

17

What is enterpathic arthritis?

An inflammatory arthritis involving the spine and peripheral joints occuring in pateints with IBD, coeliac disease and pts with extensive bowel resections

18

What is reactive arthritis?

Arthritis occurs in response to an infection in another part of the body - infection triggers and AI arthropathy

19

What are the most common infections that initiate reactive arthritis?

Shigella
Salmonella
Campylobacter
Cryptosporidium
Giardia
Chlamydia
Neisseria

20

Why is history important in rective arthritis?

If food poisioning 2/3 weeks prior then think about reactive arthritis

21

What investigations are done for reactive arthritis?

Raised inflam markers
Cultures - blood, stool, urine
Joint fluid analysis - rule out infection of joint
X-ray affected joints